Work-related musculoskeletal disorders (MSDs) are prevalent among surgeons but have received little attention because of under-reporting of injury and logistical constraints of studying surgical ergonomics.1 MSDs remain the most common work-related health problem in the European Union and workers in all sectors and occupations can be affected.2 The NHS, the UK’s largest employer, has a high rate of sickness absence due to MSDs, costing around £400m per year and the equivalent of 9.5million working days.3

Many surgeons and scrub nurses will continue to experience unnecessary pain while at work while operating due to bad posture or as a result of the instruments they use unless they get the adequate training to improve their working practices and until the occupational health departments in their organisations start becoming more involved in the ergonomics of surgery.4 Occupational health is a well-established discipline in many hospitals. Such departments have the responsibility of ensuring that the health care providers are safe at work and safe towards the patients. 

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A study involving one hundred and thirty surgeons from various subspecialties in surgery currently practicing in the United Kingdom, to investigate the prevalence of pain experienced by surgeons while operating reported back and neck were the most common areas of pain in addition posture being the most cause of pain.4 Nearly forty three per cent of the consultants reported that pain was severe enough to force them to take a break from operating to relieve their symptoms. 

Foot ache featured as one of the areas that surgeons suffered from during surgery, yet surgeons will struggle to find recommendations about appropriate footwear. In addition, many operating departments do not allow surgeons to wear footwear that they find comfortable or simply do not issue surgeons with any footwear at all.

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Nearly fifty per cent of the surveyed surgeons blamed posture for some of their symptoms. A Mayo Clinic study on surgeons found that 16 out of 17 surgeons experienced symptoms that worsened by performing surgery at an early age (mean age of 35 years), and the most common complaints were pain in the neck, shoulders, lower back and headaches.5 The study also revealed problems with the operating room setup, poor positioning and awkward posture. It is the duty of the occupational health departments to ensure that the employees have adequate training to perform their jobs safely. However, apart from manual handling training to prevent back injuries, which very few surgeons receive yet are expected to help in the transfer of patients in the operating theatres, these departments seem to lack in their guidance in the operating room. In one study, ninety seven per cent of surgeons felt that ergonomic improvements in the operating room are necessary.6 There is also a need for surgical training bodies to take the issue of the ergonomics of the operating room more seriously. Hardly any of the taught surgical curriculums teach young surgeons about the ergonomics of surgery.4 Ergonomics training should be developed to protect surgeons from preventable, potentially career-altering injuries.

In Europe work-related musculoskeletal disorders (WMSDs) remain the most common work-related health problem affecting 38%-41% of Health and Social Care workers each year.2 Surgery can often involve operating continuously for prolonged periods, frequently while standing, and operating on areas that are not easily accessible there requiring the surgeon to assume positions that may not be particularly comfortable. 

As elective surgery slowly returns and hospitals play catch up, after the effects of multiple lockdowns due to COVID-19, surgeons and scrub nurses will need nurturing. Occupational Health and theatre managers must be vigilant, proactive and invest in ergonomic equipment that reduces the risk occupational related pain which promotes better ergonomics in surgery therefore creating better patient outcomes. Anti-fatigue mats can be used to provide a comfortable standing surface for surgeons, nurses and other health professionals. Anti-fatigue mats are designed to reduce the stress and strain of muscles and joints caused from standing for extended procedures.

Contact us to find out how to reduce the risk of occupational related pain in surgery with our SANDEL Ergo-Plus Anti Fatigue Mats.


1. Catanzarite T, Tan-Kim J, Menefee SA. Ergonomics in gynecologic surgery. Curr Opin Obstet Gynecol. 2018 Dec;30(6):432-440. doi: 10.1097/GCO.0000000000000502. PMID: 30299323. 
2. European Agency of Safety at Work. Summary - Work-related musculoskeletal disorders: prevalence, costs and demographics in the EU. 15/11/2019.  Accessed: May 2021
3. The Royal College of Physcians. Work and Wellbeing in the NHS: Why staff health matters to patient care. 2015.  Accessed: May 2021
4.  A. Soueid, D. Oudit, S. Thiagarajah, G. Laitung. The pain of surgery: Pain experienced by surgeons while operating. International Journal of Surgery.2010;8(2):118-120. ISSN 1743-9191,2.
5. Esser A, Koshy JG, Randle HW. Ergonomics in office-based surgery: a survey guided observational study. Dermatological Surgery 2007;33(11):1304–14.
6.  Matern U, Koneczny S. Safety, hazards and ergonomics in the operating room. Surgical Endoscopy 2007;25(11):1965–9.

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